Physical Therapy, an Alternative to the High Risks of Methadone

An investigative report published February 2003, in the New York Times, highlights the alarming increase in methadone prescriptions for the treatment of chronic spinal pain. The result has been a shocking increase in methadone related deaths. Sept. 30, 2009, Methadone deaths have risen sevenfold in less than a decade, according to a government report that largely blames the increase on the growing use of methadone for pain relief. In addition, drug deaths now outnumber traffic fatalities in the United States. Drugs exceeded motor vehicle accidents as a cause of death in 2009, killing at least 37,485 people nationwide, according to preliminary data from the U.S. Centers for Disease Control and Prevention. The Drug enforcement Administration noted that from 1998 to 2006, the number of methadone prescriptions increased by 700 percent. Many legitimate patients, following the direction of their doctor, have run into trouble with methadone, including death.

More recently and in our own neighborhood, we have seen the senseless deaths of innocent people while others attempt to steal these pain medications right out of the pharmacies. I’ve seen how this affects people in our neighborhood; it has negatively affected many people for the rest of their lives, both the users and their families, and the innocent by standers. Attempts need to be made to decrease the dependence on these highly addictive medications.

As a physical therapist, I know how we can play a role in providing patients and physicians with an alternative to dangerous pain medications like oxycodone and methadone. Methadone was once limited to use in addiction treatment centers to replace heroin, but today it is frequently given out by physicians to manage spine pain, joint pain, and other related chronic pain.

Patients should be aware that these medications are not the best option to reduce the symptoms of spinal pain. Research has shown that early movement and treatments like soft tissue mobilization, myofascial release, spinal manipulation, and exercise offer strong benefits to spine pain and disability. We too often initiate prescription drug therapy before choosing safe and effective alternatives. Many people in the medical community suggest that patients seek out physical therapists as a first-line treatment for these conditions.

A February 2008 report published in the Journal of the American Medical Association reports that from 1997 to 2005, pharmaceutical expenditures for the management of low back pain increased by 171% while the rate of good outcomes fell. “All the imaging we do, all the drug treatments, all the injections, all the operations have some benefit for some patients,” said Richard A. Deyo, a physician at Oregon Health & Science University in Portland and a coauthor of the report. “But I think in each of those situations we’ve begun using those tests or treatments more widely than science would really support.”

For more on the benefits physical therapists can provide in the management of spinal pain, contact us at Spectrum Physical Therapy or visit the American Academy of Orthopaedic Manual Physical Therapists website at www.aaompt.org. AAOMPT represents physical therapists by promoting excellence in orthopaedic manual physical therapy practice, education and research. You can also visit the American Physical Therapy Association (APTA) website http://www.moveforwardpt.com for information on symptoms and conditions, why physical therapy, patient resources, and how to find a local physical therapist.

If you have any questions, feel free to contact myself, or one of our therapists.